History

Methamphetamine (also known as “meth” or “speed”) is a more potent form of amphetamine, which is derived from ephedrine or pseudoephedrine. Methamphetamine was first created for illicit use by West Coast motorcycle gangs in the late 1970s. These “cooks” discovered that a drug with similar properties to amphetamine could be created using ephedrine, which can be found in over-the-counter cold medication, and household ingredients. This psychoactive stimulant became popular after amphetamine’s key ingredient began being regulated by the United States government in 1980. Without easy access to amphetamines, many addicts switched to methamphetamine. The West Coast gangs began obtaining the necessary ephedrine and pseudoephedrine from medications and from Mexico to maintain their new business, and the drug soon spread. Although the federal government has tried numerous times to curb cooks’ ability to obtain ephedrine and pseudoephedrine, lack of regulation in neighboring countries, particularly Mexico, and pushback from the pharmaceutical companies has hindered their ability to exterminate the drug. It is now popular in many areas of the West Coast, Midwest, and South regions of the United States.

How It’s Used

Typical ingestion of meth is either done through smoking (sometimes called “chasing the dragon”) or through injection. Methamphetamine has a half-life of approximately 10 hours, making its “high” last much longer than many other psychostimulants. Despite this, meth addicts will often go on binges, taking the drug approximately every 2 hours for periods as long as 3-6 days. The user will also sometimes add in depressants, such as alcohol or barbiturates, or even heroin (called a “speedball”) to prolong the high and prevent a “crash” when the drug wears off. These binges, or “runs,” finally end when the user runs out of energy and passes out for many hours.

How It Works

Methamphetamine is similar to cocaine in that it acts on the transporters which remove catecholamine neurotransmitters (dopamine and norepinephrine) from their active sites. It causes these transporters to work in reverse, forcing them to push out more of these catecholamines. Additionally, meth enters neurons and forces out more of these neurotransmitters from their storage sites, and can even inhibit the breakdown of these neurotransmitters at high doses. All of these mechanisms combine to increase neuronal activity in brain regions associated with reward and motivation.

As with other stimulants, methamphetamine increases blood pressure, heart rate, breathing rate, and body temperature. Mild methamphetamine use results in increased awareness, elevated self-confidence, euphoria, increased performance on simple tasks, and decreased physical and mental fatigue. However, chronic use of this drug can lead to delusions, hallucinations, anorexia, and hostility, as well as increased risk of heart attack and stroke. Additionally, chronic use has been shown to cause premature aging, resulting in significant physical deterioration of skin and muscle tissue.

Repeated methamphetamine use commonly leads to dependence on the drug. When a chronic user decides to abstain from using the drug, they suffer from a withdrawal syndrome consisting of depression, anxiety, decreased sleep, decreased cognitive ability, irritability, decreased energy, increased appetite, and a craving for the drug to alleviate these symptoms. These symptoms can last several weeks, thus making relapse a common occurrence in methamphetamine users.

Treatment

As with many other drugs of abuse, there are currently no medications that have been proven to treat methamphetamine abuse. The primary treatments for this drug are behavioral in nature, such as contingency management, cognitive behavioral therapy, and the Matrix Model. In contingency management, patients are given points or tickets in exchange for clean urine tests, which can be traded in for items that sponsor healthy living, such as club/gym memberships, dinners, and excursions. This method is used to encourage patients to stay in treatment and help with the initial abstinence from cocaine. Cognitive-behavioral therapy is designed to help patients develop skills and coping mechanisms to continue their abstinence after leaving treatment. These skills include recognizing situations and environments where they are at risk of relapsing and learning how to avoid them. The Matrix Model involves a 16- weeks comprehensive behavioral treatment plan involving behavioral therapy, family education, individual counseling, 12-Step support, and encouragement for healthy living activities and has been proven effective in treating methamphetamine abuse.